Archived: Midmoor Road

Updated 2 February 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 1 December 2015 and was announced. The provider was given 48 hours’ notice because the location was a small care home for younger adults who are often out during the day, and we needed to be sure that someone would be in. The inspection was carried out by one adult social care inspector.

Before the inspection we checked information we held about the service and the provider. This included previous inspection reports and statutory notifications sent to us about incidents and events that happened at the service. A notification is information about an event which the service is required to tell us about by law. We also contacted the local Healthwatch, the local authority commissioners for the service, and the clinical commissioning group [CCG]. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to decide what areas to focus on during the inspection.

The six people who lived at this home had complex needs that limited their communication. This meant that they could not tell us in detail about living at the service. We asked relatives for their views on the service.

We looked at a range of records about people’s care and how the home was managed. These included the care records of two people, the recruitment records of three staff, training records and quality monitoring records. We spoke to two relatives and two health care professionals who visit the service on a weekly basis.

Updated 2 February 2016

This announced inspection took place on 1 December 2015. The last inspection of this home was carried out on 5 March 2013. The service met all the regulations we inspected against at that time.

Midmoor Road provides care and support for up to six people who have learning disabilities or physical disabilities. At the time of the visit six people were using the service.

The home had a previous registered manager who had been transferred to another service within the organisation. Therefore was not actively managing Midmoor Road. They had however not submitted an application to cancel their registration. We are dealing with this outside of the inspection process. We understand it is the intention of the newly appointed service manager to apply for registration with the Care Quality Commission. The service had a service coordinator who was responsible for the day to day running of the home. Both the service manager and service coordinator were new to post at Midmoor Road but not to the organisation.

The registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The people who lived at the home had complex needs which meant they were unable to tell us in detail about the service. We spoke to relatives to get their views on the service. Relatives made positive comments about the service and said people enjoyed being at the home. One relative told us “[family member] is happy at Midmoor Road. That is all we want for [family member].”

Staff had a clear understanding of safeguarding and whistleblowing. They were confident that any concerns would be listened to and investigated. Staff told us how safeguarding alerts were managed in the service. One member of staff told us, “I would report it to the manager who would then notify the safeguarding team.” Staff were able to give examples of different types and definitions of abuse and how to recognise changes in behaviour.

Staff understood the Mental Capacity Act 2005 (MCA) regarding people who lacked capacity to make a decision. They also understood the Deprivation of Liberty Safeguards (DoLS) to make sure people were not restricted unnecessarily.

We looked at staffing rotas both current and historical. There were enough staff employed to ensure people were supported both in the service and when out in the community. Relatives told us they felt the staff were appropriately trained to support their family member. One relative told us, “[family member] settled in straight away, they are out and about with support from staff, it is clear they know how to care.”

Recruitment practices at the service were robust, appropriate and safe. So only people suited to the role were employed by the service. Staff told us, the team in the service was stable with some members being long term employees. Staff training was up to date and staff received frequent supervision and appraisal. An annual planner was in place to begin staff appraisals for 2016.

People had individual rooms which were comfortably furnished in accordance with people’s choices and preferences. Staff told us that family members brought in personal effects. Equipment was in place to support safe moving and assisting.

People’s choices were acknowledged wherever possible. People had a range of activities they could take part in. People were supported to be involved in choosing menus with staff using pictures to check what they liked and disliked. People’s dietary needs were respected and were taken into account when the four weekly varied menu was developed. We saw involvement with the Speech and Language Team to support people’s health and wellbeing regarding eating and drinking.

Relatives felt involved in decisions about their family member’s care and were kept fully informed of any changes. Relatives made many positive comments about the service. For example one relative commented that, they had nothing negative to say about the service. They described the service as being safe for their family member.

We saw genuine relationships between staff and people who use the service. Staff were caring and compassionate. People were at ease with how staff supported them, which was seen by positive body language and facial expressions.

People’s care records and risk assessments showed us that people were encouraged to be as independent as possible, with life skills being promoted. People’s healthcare needs were regularly monitored and assessed. Contact was made with other health care professionals, such as GPs, community nurses and occupational therapists when necessary. Staff used alternative forms of communication such as pictures and gestures to communicate with people.

We saw systems were in place for recording and managing safeguarding concerns, complaints, accidents and incidents. One relative we spoke to did not know how to make a formal complaint, but told us they would approach the manager.

Relatives and staff told us the organisation was well run and the home was well managed. There were no concerns raised by other health and social care organisations that we contacted before the inspection.

Staff told us the management was open, supportive and approachable. They acknowledged that there may be changes with new managers being in post but were confident that changes would only improve Midmoor Road.

Policies and procedures were in place to ensure medicines were managed in a safe way. Records were up to date with no gaps or inaccuracies found. A staff signing sheet was available so records could be audited. Staff were trained in safe handling of medicines and received regular medicine competency checks.

The service did not have a process in place for capturing the views of staff, people who use the service, relatives or other stakeholders to monitor the quality of the service.